Abstract:

OBJECTIVE:

METHOD:

RESULTS:

Complete remission of psychiatric symptoms without recurrence for the next 4 years with vitamin B12 as the only specific therapy instituted.

CONCLUSION:

Importance of B12 estimation and replacement in patients with varied psychiatric manifestations.

FAB RESEARCH COMMENT:

This case study starkly illustrates the importance of clinicians considering nutrition (as well as other lifestyle factors) when assessing and treating anyone with 'psychiatric' symptoms, rather than pressing ahead with pharmaceutical or other treatments that are known to carry a high risk of negative side-effects.

It describes the case of a 57-year old woman who endured many months of unsuccessful treatment with both antipsychotic and antidepressant medications, as well as two sessiohs of ECT (electro-convulsive therapy), simply because her doctors never thought to assess her vitamin B12 status.

Deficiencies of vitamin B12 are not uncommon in the general population - but are especially common in older adults (because levels of 'intrinsic factor', needed to absorb dietary B12, tend to fall with increasing age), and also in anyone following a vegetarian or vegan diet. (Vitamin B12 supplements are absolutely vital for vegans, as this nutrient is found only in foods of animal origin).

That B12 deficiency can directly cause psychiatric and/or neurological symptoms is a long-established fact - and furthermore, prolonged deficiency can lead to serious and irreversible impaitments of brain and nervous system functioning. However, medical training overwhelmingly emphasises pharmaceutical, surgical or other 'mechanistic' approaches rather than considering diet, nutrition and other relevant lifestyle factors.

This lack of attention to nutrition ugently needs to change - and while the need for better training in nutrition for health professionals applies to all branches of medicine and publuc health, it is particularly relevant in psychiatry, where effective methods of both diagnosis and treatment are relatively lacking, while the prevalence of mental health problems continues to increase.

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